Relocation Stories #2 - Health Coverage

Two weeks ago, we spoke with Ms Lucks, Director of my daughter’s preschool, about finding a suitable “Kita” (nursery/ preschool) in Berlin. Today, I want to share the conversation we had with Michael Zeletzky from Techniker Krankenkasse (TK), the largest health insurance company in Germany. He is an expert in health care and supports expats managing the German healthcare system.

Please introduce yourself and your insurance!

I am Michael Zeletzky, married and have two adult daughters. I have been working for various health insurance companies for more than 20 years and have been working for the past seven years at the Techniker Krankenkasse (TK). TK is a nationwide statutory health insurance company with more than 11 million insured persons. As one of the most modern and efficient health insurance companies in Germany, TK offers the best package of benefits, service and an attractive contribution rate. Techniker Krankenkasse is repeatedly honored for this. In 2021, Focus Money named it Germany's best health insurance for the 15th time in a row.?

What is the difference between a statutory and a private health insurance?

In Germany, health insurance is provided by two different systems: statutory health insurance (SHI - GKV (German)) and private health insurance (PHI - PKV (German)). Statutory health insurance provides reliable health protection for 90 percent of the population: around 70 million citizens are insured here to receive the best possible medical care.?

The SHI system operates on the principle of solidarity: contributions are based on the financial capacity of the insured, and most health benefits are largely the same for everyone. All members with statutory health insurance generally pay income-related contributions. Regardless of the amount of contributions paid, all insured persons receive the medically necessary services.?

Also, the SHI allows children and spouses to be insured free of charge with a family insurance policy.

In contrast to SHI, membership in a PHI scheme is not possible for everyone. Employees can be insured in the PHI scheme if their monthly gross income is above the income threshold (2021: € 5,362.50 per month). PHI often requires a minimum period for permanent residence (e.g. 2 years) in Germany. Many private insurance companies offer special rates for expats, which are adapted to the length of the stay and their needs. With PHI you have more control over what is covered and can adapt it to your individual needs.??

Whereas in the SHI the premiums are largely based on the income of the insured, the premium in PHI are based on the state of health, age and scope of benefits and are different for each individual policyholder. If you apply for a PHI scheme, you will be asked detailed questions about your current state of health. As with other private insurances, freedom of contract also applies to PHI. In contrast to SHI, PHI are generally not obliged to conclude insurance contracts. Applicants can therefore also be rejected because of pre-existing conditions or age.?

Lastly, children and spouses are normally not insured free of charge in PHI.?

My personal tip: If you want to learn more about the German health insurance system, go visit this blog which offers a great overview in English.?

Which insurance is the best for me?

In Germany, you are free to choose. This applies not only to politics but also to health insurance. Every person over the age of 15, whether voluntarily or compulsorily insured, may choose a health insurance company. This only does not apply to a few groups of people, such as privately insured persons over the age of 55. The option to choose is intended to ensure a certain degree of competition among the health insurance funds and enable each person to take out the appropriate health insurance policy.?

Which health insurance fund is the best choice depends primarily on one's own ideas. Some want to have low-cost health insurance. Others want to take advantage of certain benefits, such as for young families or retirees. Who has certain wishes in terms of health insurance, should note them down before a comparison, so that you can filter out the appropriate insurance.

Health insurance tests published by major magazines or interest groups are helpful. One of the best known and also the largest is the annual health insurance comparison by Focus Money. Here, TK was named Germany's best health insurer for the 15th time in a row (FM-Kassenvergleichstest 2021, German only ??).

What is special about your insurance company?

Switching health insurance to TK offers many advantages because with TK you receive a diverse range of benefits for your premium in every situation in life, which you can shape entirely according to your individual needs.

The range of services offered by TK includes more than 10,000 individual benefits and thus goes far beyond the benefits catalog prescribed by law. TK also takes into account the individual needs of its customers. Whether you are a trainee or student, an employee or self-employed person, a pensioner or a family member - TK is a reliable partner in every situation in life.?

Here are a few important examples:

TK contracts with specialists: from outpatient surgery to therapy for chronic illnesses - Techniker offers a comprehensive care concept for a range of treatment areas. The individual therapy steps are better coordinated. Your treatment becomes more efficient.

Travel vaccinations:? For private trips abroad, Techniker covers the costs of the necessary vaccination and malaria prophylaxis, minus the statutory co-payment for the vaccine if applicable.

TK appointment service: Getting an appointment with a general practitioner or specialist is not always easy. That's why we support you with the TK-TerminService if things don't work out the way you want them to.

TK members can also optimise their insurance coverage with an exclusive range of supplementary insurance policies - tailored to their individual needs.

Are your services in English??

Our application process is entirely in English, so you can become a member quickly and easily. The process covers every step - from the application form to the sending of the electronic health card.

Also, our TK app is in English. Our app offers you many functions for dealing with your concerns - conveniently on your smartphone. For example, you can send us your sick notes and documents, use the TK bonus program or our TK Fit Challenge completely digitally, download the membership certificate for your employer or submit costs for vaccinations and osteopathy.

If you have any questions or need more information, you can reach us at any time, seven days a week. And no, we don't just speak English, we also offer support in many other languages.

Thank you Mr. Zeletzky for the interesting insights!?

If you want to learn more about the TK go visit the following links:?

• ?Become a member with a lot of tips for expats
• Mr Zeletzkys Contact Details?

?In our next interview, we will look at the Berlin housing market and try to solve the question of how to find a suitable apartment remotely.